In excess of six million units blood are collected for transfusion in India annually. Yet there are only two institutions in the entire country that provide comprehensive training programs in transfusion medicine. The limited technical expertise in transfusion medicine in India is also demonstrated by the fact 1/3 of the Approximately 1000 blood banks in India are unlicensed and the majority of blood collected in India is used for single unit transfusions. Despite legislation requiring compulsive testing of blood for syphilis, HIV and HBV in India, some estimates suggest that only 2/3 of all donated blood is properly screened. India, with a population of 1 billion and millions of transfusions per year urgently requires additional expertise and the latest technology for the safe utilization of blood products. This Fogarty proposal has the following four specific aims: To train Indian scientists in the epidemiology of transfusion associated diseases and programmatic issues for prevention of transfusion associated diseases and proper clinical utilization of blood products. To train investigators from India in Good Laboratory Practices for blood banks, as well as training in the current laboratory assays and procedures for screening blood for transfusion associated diseases including HIV, HBV, HCV and CMV. To provide a series of in-country workshops focused on the latest procedures and techniques in transfusion medicine, organized and directed by Indian scientists trained by the Fogarty Program at JHU. To initiate a number of pilot research studies designed to identify critical barriers to the safe and appropriate collection and use of blood products in India. This administrative supplement to our existing Fogarty AITRP awards seeks to continue and expand the training and in-country research efforts of this collaboration. Specifically, we propose the following training activities: Year I Seven short course trainees (Epidemiology/Blood Band Program Management (3), Blood Bank Laboratory assays. Year II Five short course trainees (Epidemiology/Blood Band Program Management (3), Blood Bank Laboratory Assays/Procedures (2). Two in- country workshops. Year III Two in-country workshops plus 2 Advanced Research Training Awards.